Journal articles on the topic 'Infants Weight Measurement Evaluation'
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1
Prado, Camila Carbone, Roberto José Negrão Nogueira, Antônio de Azevedo Barros-Filho, Elizete Aparecida Lomazi da Costa-Pinto, and Gabriel Hessel. "Growth evaluation in infants with neonatal cholestasis." Arquivos de Gastroenterologia 43, no. 4 (December 2006): 305–9. http://dx.doi.org/10.1590/s0004-28032006000400012.
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BACKGROUD: Chronic liver diseases in childhood often cause undernutrition and growth failure. To our knowledge, growth parameters in infants with neonatal cholestasis are not available AIM: To evaluate the nutritional status and growth pattern in infants with intrahepatic cholestasis and extrahepatic cholestasis. PATIENTS AND METHODS: One hundred forty-four patients with neonatal cholestasis were followed up at the Pediatric Gastroenterology Service of the Teaching Hospital, State University of Campinas, Campinas, SP, Brazil, in a 23-year period, from 1980 to 2003. The records of these patients were reviewed and patients were classified into two groups, according to their anatomical diagnosis: patients with intrahepatic cholestasis - group 1, and patients with extrahepatic cholestasis - group 2. Records of weight and height measurements were collected at 4 age stages of growth, in the first year of life: 1) from the time of the first medical visit to the age of 4 months (T1); 2) from the 5th to the 7th month (T2); 3) from the 8th to the 10th month (T3); and 4) from the 11th to the 13th month (T4). The weight-by-age and height-by-age Z-scores were calculated for each patient at each stage. In order for the patient to be included in the study it was necessary to have the weight and/or height measurements at the 4 stages. Analyses of variance and Tukey's tests were used for statistical analysis. Repeated measurement analyses of variance of the weight-by-age Z-score were performed in a 60-patient sample, including 29 patients from group 1 and 31 patients from group 2. The height-by-age data of 33 patients were recorded, 15 from group 1 and 18 from group 2 RESULTS: The mean weight-by-age Z-scores of group 1 patients at the 4 age stages were: T1=-1.54; T2=-1.40; T3=-0.94; T4=-0.78. There was a significant difference between T2 X T3 and T1 X T4. The weight-by-age Z-scores for group 2 patients were :T1=-1.04; T2=-1.67; T3=-1.93 and T4=-1.77, with a significant difference between T1 X T2 and T1 X T4. The mean weight-by-age Z-scores also showed a significant difference between group 1 and group 2 at stages T3 and T4. The mean height-by-age Z-scores at the four stages in group 1 were: T1=-1.27; T2=-1.16; T3=-0.92 and T4=-0.22, with a significant difference between T3XT4 and T1XT4. The scores for group 2 patients were: T1=-0.93; T2=-1.89; T3=-2.26 and T4=-2.03, with a significant difference between T1XT2 and T1XT4. The mean height-by-age Z-scores also showed a significant difference between group 1 and group 2 at T3 and T4 CONCLUSION: The weight and height differences between the groups became significant from the 3rd measurement onward, with the most substantial deficit found in the extrahepatic group. In this group, there is evidence that the onset of weight and height deficit occurs between the first and second evaluation stages.
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Pitchford, E. Andrew, Leah R. Ketcheson, Hyun-Jin Kwon, and Dale A. Ulrich. "Minimum Accelerometer Wear Time in Infants: A Generalizability Study." Journal of Physical Activity and Health 14, no. 6 (June 2017): 421–28. http://dx.doi.org/10.1123/jpah.2016-0395.
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Background:Research measuring physical activity behaviors during infancy is critical for evaluation of early intervention efforts to reduce rapid weight gain. There is little known about the physical activity patterns of infants, due in part to limited evidence for measurement procedures. This study sought to determine the minimal number of days and hours of accelerometry needed to reliably measure daily physical activity in infants using Generalizability (G) theory.Methods:A total of 23 infants (14 female, 9 male) wore an accelerometer on the right ankle and right wrist for 7 days. Data were manually cleaned to remove activity counts not produced by the infant. G theory analyses were conducted on the average counts per epoch.Results:Reliable estimates were observed with at least 2 days (G & Φ = .910) and 12 hours (G = .806, Φ = .803) at the ankle, and with at least 3 days (G & Φ = .906) and 15 hours (G = .802, Φ = .800) at the wrist.Conclusions:These results provide some of the first guidelines for objective physical activity measurement during infancy. Accelerometer monitoring periods of at least 3 days including all daytime hours appear to be sufficient for reliable measurement.
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LIN, SHIH-CHING, CHING-HSING LUO, and TSU-FUH YEH. "IMPROVE ON PERFORMANCE OF INDIRECT CALORIMETRY FOR SMALL PRETERM INFANTS." Biomedical Engineering: Applications, Basis and Communications 13, no. 03 (June 25, 2001): 109–15. http://dx.doi.org/10.4015/s1016237201000145.
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An indirect calorimetry system of measuring oxygen consumption and carbon dioxide production has been frequently used for preterm infants. The energy consumption and metabolic measurements are based on flow-through technology. The noninvasive measurement feature of the indirect calorimeter is widely used in pediatric clinical research. However, the indirect calorimeter has several limitations for small preterm infants, particularly the ill infant weighing < 1.0 kg. In this paper, we propose some technologies and methodologies to improve the performance of the indirect calorimetry. According to these technologies and methodologies, we redesign the indirect calorimeter proposed in our pervious study. The laboratory evaluation at the different alcohol combustion rates and several exhaust flow rates is used to survey the improved performance. As the results, the accuracy and precision is enhanced by these methods and the lowest oxygen consumption rate, 4.35 ml/min, fits for baby weight of 0.66 kg. It is demonstrated that the performances of new indirect calorimetry are substantially improved. It can be applied to calculate the energy consumption and metabolic rate for low-birth-weight infants in clinical research.
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Healy, David B., Eugene M. Dempsey, John M. O’Toole, and Christoph E. Schwarz. "In-Silico Evaluation of Anthropomorphic Measurement Variations on Electrical Cardiometry in Neonates." Children 8, no. 10 (October 18, 2021): 936. http://dx.doi.org/10.3390/children8100936.
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Non-invasive cardiac output methods such as Electrical Cardiometry (EC) are relatively novel assessment tools for neonates and they enable continuous monitoring of stroke volume (SV). An in-silico comparison of differences in EC-derived SV in relation to preset length and weight was performed. EC (ICON, Osypka Medical) was simulated using the “demo” mode for various combinations of length and weight representative of term and preterm infants. One-centimetre length error resulted in a SV-change of 1.8–3.6% (preterm) or 1.6–2.0% (term) throughout the tested weight ranges. One-hundred gram error in weight measurement resulted in a SV-change of 5.0–7.1% (preterm) or 1.5–1.8% (term) throughout the tested length ranges. Algorithms to calculate EC-derived SV incorporate anthropomorphic measurements. Therefore, inaccuracy in physical measurement can impact absolute EC measurements. This should be considered in the interpretation of previous findings and the design of future clinical studies of EC-derived cardiac parameters in neonates, particularly in the preterm cohorts where a proportional change was noted to be greatest.
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Suharjito, Suharjito, Jimmy Jimmy, and Abba Suganda Girsang. "Mobile Decision Support System to Determine Toddler's Nutrition Using Fuzzy Sugeno." International Journal of Electrical and Computer Engineering (IJECE) 7, no. 6 (December 1, 2017): 3683. http://dx.doi.org/10.11591/ijece.v7i6.pp3683-3691.
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Determination of nutritional status is closely related to the determination of dietary patterns should be given to infants. Nutrition is very important role in mental, physical development, and human productivity. In this study, the system based on android is developed to determine the nutritional status of infants by using Fuzzy Sugeno. Indicator variables are age, height, circle head, and body weight according to the male or female. In this study, the results of measurements of nutritional status of children with Fuzzy Sugenoare tested by comparing the nutritional quality of the data Posyandu toddler by using anthropometric tables. The results of the evaluation measurement accuracy in this application are compared with the results of manual calculation based infant growth charts according to WHO standards. Therefore, these applications can be used to help the community in monitoring the nutritional status of children so that the growth of children is more appropriate in line with expectations.
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Buchwald, Andrea G., Ibrahima Teguete, Moussa Doumbia, Fadima C. Haidara, Flanon Coulibaly, Fatoumata Diallo, Samba O. Sow, William C. Blackwelder, and Milagritos D. Tapia. "Clinical Evaluations Have Low Sensitivity for Identifying Preterm Infants in a Clinical Trial in a Limited Resource Setting." Global Pediatric Health 6 (January 2019): 2333794X1985740. http://dx.doi.org/10.1177/2333794x19857402.
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Preterm birth is a primary outcome of interest in maternal vaccination trials but determination of gestational age is challenging in limited-resource settings. This study compares the New Ballard Score and fundal height measurements with the current standard of early ultrasound for sensitivity of predicting preterm birth. A trial of maternal influenza vaccination was conducted in Bamako, Mali. The New Ballard Score and fundal height were collected on 4038 infants born in the trial, ultrasound data were available for 1893 of those infants. New Ballard Score and fundal height were compared, consecutively, to all ultrasound results, early ultrasound results from the first trimester, and the date of last menstrual period for estimation of gestational age. Sensitivity of the New Ballard Score for identifying preterm infants was 0.33 compared with early ultrasound and 0.1 compared with the last menstrual period based estimates of gestational age. Sensitivity of low birth weight alone was 0.43 compared with early ultrasound. New Ballard Score estimated gestational age within 1 week of ultrasound more frequently than fundal height (53% compared with 7.6%, respectively) yet New Ballard Score identified few infants as preterm (1.8% vs 5.8% by early ultrasound), and was biased toward categorizing low birth weight infants and infants requiring hospitalization as preterm. New Ballard Score is not an ideal measure for identifying preterm births in low-resource settings. Despite the time and cost of training required for correct measurement of New Ballard Score, measurement of low birth weight alone performed better than New Ballard Score for identifying preterm infants.
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Davies, Peter S. W., G. Ewing, and A. Lucas. "Energy expenditure in early infancy." British Journal of Nutrition 62, no. 3 (November 1989): 621–29. http://dx.doi.org/10.1079/bjn19890062.
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The measurement of energy expenditure has wide applications in clinical and scientific studies. Ethical and practical problems, however, have limited the acquisition of information on total energy expenditure in infancy. The doubly-labelled-water technique, recently validated for use in infants, has now been used to measure, non-invasively, total energy expenditure in a cohort of forty-one normal, full-term infants at or close to 1·5, 3 and 6 months of age. Mean total energy expenditure was 270, 280 and 330 kJ/kg per d at these ages. Centiles for total energy expenditure in early infancy are presented; it is suggested such data are most appropriately expressed as kJ/√ (kg body-weight per d). These findings will be of importance in the re-evaluation of energy requirements in infancy and in the study of lesions in energy metabolism in disease states at this age.
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Perrone, Michela, Camilla Menis, Pasqua Piemontese, Chiara Tabasso, Domenica Mallardi, Anna Orsi, Orsola Amato, Nadia Liotto, Paola Roggero, and Fabio Mosca. "Energy Expenditure, Protein Oxidation and Body Composition in a Cohort of Very Low Birth Weight Infants." Nutrients 13, no. 11 (November 6, 2021): 3962. http://dx.doi.org/10.3390/nu13113962.
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The nutritional management of preterm infants is a critical point of care, especially because of the increased risk of developing extrauterine growth restriction (EUGR), which is associated with worsened health outcomes. Energy requirements in preterm infants are simply estimated, so the measurement of resting energy expenditure (REE) should be a key point in the nutritional evaluation of preterm infants. Although predictive formulae are available, it is well known that they are imprecise. The aim of our study was the evaluation of REE and protein oxidation (Ox) in very low birth weight infants (VLBWI) and the association with the mode of feeding and with body composition at term corrected age. Methods: Indirect calorimetry and body composition were performed at term corrected age in stable very low birth weight infants. Urinary nitrogen was measured in spot urine samples to calculate Ox. Infants were categorized as prevalent human milk (HMF) or prevalent formula diet (PFF). Results: Fifty VLBWI (HMF: 23, PFF: 27) were evaluated at 36.48 ± 0.85 post-conceptional weeks. No significant differences were found in basic characteristics or nutritional intake in the groups at birth and at the assessment. No differences were found in the REE of HMF vs. PFF (59.69 ± 9.8 kcal/kg/day vs. 59.27 ± 13.15 kcal/kg/day, respectively). We found statistical differences in the protein-Ox of HMF vs. PFF (1.7 ± 0.92 g/kg/day vs. 2.8 ± 1.65 g/kg/day, respectively, p < 0.01), and HMF infants had a higher fat-free mass (kg) than PFF infants (2.05 ± 0.26 kg vs. 1.82 ± 0.35 kg, respectively, p < 0.01), measured with air displacement plethysmography. Conclusion: REE is similar in infants with a prevalent human milk diet and in infants fed with formula. The HMF infants showed a lower oxidation rate of proteins for energy purposes and a better quality of growth. A greater amount of protein in HMF is probably used for anabolism and fat-free mass deposition. Further studies are needed to confirm our hypothesis.
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Gunn, Tania R., and Shirley L. Tonkin. "Upper Airway Measurements During Inspiration and Expiration in Infants." Pediatrics 84, no. 1 (July 1, 1989): 73–77. http://dx.doi.org/10.1542/peds.84.1.73.
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Accurate measurements of the upper airway of the infant are important but are difficult to obtain reliably because of the normal variation that occurs during respiration. X-ray films of the lateral upper airway were obtained during inspiration and expiration in healthy infants, by using as a timing device a respiration monitor which was wired to the x-ray machine and was attached to the abdominal wall of the infant. Cephalometric measurements were made of 44 "normal" full-term neonates and 29 infants at 6 weeks of age. Despite significant differences in head circumference between the sexes, only the nasion to sella length was significantly longer in the boys (P < .01). The lateral upper airway measurements were independent of weight, head circumference, and sex in the neonates and infants at 6 weeks of age but were significantly smaller during inspiration than expiration (P < .01). The measurements progressively increased from the middle to the posterior airway space at both ages. The middle airway space behind the caudal end of the hard palate was smaller during inspiration at 6 weeks of age compared to the neonate (P < .01). During expiration, the posterior airway space was larger at 6 weeks compared to the neonate (P < .01). The method described in this report enables reliable roentgenographic measurements to be made of the upper airway of the infant; normal values for the changes during inspiration and expiration are provided. This may assist in the evaluation of infants with suspected upper airway obstruction.
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Daniels, Victoria C., Marcia H. Monaco, Mei Wang, Johanna Hirvonen, Henrik Max Jensen, Arthur C. Ouwehand, Ratna Mukherjea, Ryan N. Dilger, and Sharon M. Donovan. "Evaluation of 2’-Fucosyllactose and Bifidobacterium longum Subspecies infantis on Growth, Organ Weights, and Intestinal Development of Piglets." Nutrients 14, no. 1 (December 31, 2021): 199. http://dx.doi.org/10.3390/nu14010199.
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Human milk is rich in oligosaccharides that influence intestinal development and serve as prebiotics for the infant gut microbiota. Probiotics and 2’-fucosyllactose (2’-FL) added individually to infant formula have been shown to influence infant development, but less is known about the effects of their synbiotic administration. Herein, the impact of formula supplementation with 2’-fucosyllactose (2’-FL) and Bifidobacterium longum subsp. infantis Bi-26 (Bi-26), or 2’-FL + Bi-26 on weight gain, organ weights, and intestinal development in piglets was investigated. Two-day-old piglets (n = 53) were randomized in a 2 × 2 design to be fed a commercial milk replacer ad libitum without (CON) or with 1.0 g/L 2’-FL. Piglets in each diet were further randomized to receive either glycerol stock alone or Bi-26 (109 CFU) orally once daily. Body weights and food intake were monitored from postnatal day (PND) 2 to 33/34. On PND 34/35, animals were euthanized and intestine, liver and brain weights were assessed. Intestinal samples were collected for morphological analyses and measurement of disaccharidase activity. Dry matter of cecum and colon contents and Bifidobacterium longum subsp. infantis abundance by RT-PCR were also measured. All diets were well tolerated, and formula intake did not differ among the treatment groups. Daily body weights were affected by 2’-FL, Bi-26, and day, but no interaction was observed. There was a trend (p = 0.075) for greater total body weight gain in CON versus all other groups. Jejunal and ascending colon histomorphology were unaffected by treatment; however, there were main effects of 2’-FL to increase (p = 0.040) and Bi-26 to decrease (p = 0.001) ileal crypt depth. The addition of 2’-FL and/or Bi-26 to milk replacer supported piglet growth with no detrimental effects on body and organ weights, or intestinal structure and function.
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Sampurna, Mahendra Tri Arif, Muhammad Pradhika Mapindra, Muhammad Pradhiki Mahindra, Kinanti Ayu Ratnasari, Siti Annisa Dewi Rani, Kartika Darma Handayani, Dina Angelika, et al. "Kramer Score, an Evidence of Its Use in Accordance with Indonesian Hyperbilirubinemia Published Guideline." International Journal of Environmental Research and Public Health 18, no. 11 (June 7, 2021): 6173. http://dx.doi.org/10.3390/ijerph18116173.
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Background: In some hospitals in low/middle-income countries, methods to determine the bilirubin level in newborn infants are unavailable and based on a clinical evaluation, namely a clinical score designed by Kramer. In this study, we evaluated if this score can be used to identify those infants that need phototherapy. Method: Infants admitted between November 2018 and June 2019 to three hospitals in Surabaya, Indonesia were included. The jaundice intensity was scored using the Kramer score. Blood was sampled for total serum bilirubin (TSB) measurement. The infants were categorized into Treatment Needed (TN) group when treatment with phototherapy was indicated and the No Treatment Needed (NTN) group when phototherapy was not indicated, based on the Indonesian Guideline for hyperbilirubinemia. Result: A total of 280 infants with a mean birth weight of 2744.6 ± 685.8 g and a gestational age of 37.3 ± 2.3 weeks were included. Twenty-seven of 113 (24%) infants with Kramer score 2 needed phototherapy, compared with 41 of 90 (46%) infants with score 3 and 20 of 28 (71%) of infants with score 4. The percentage of infants that needed phototherapy was higher with decreasing gestational age. Conclusion: The Kramer score is an invalid method to distinguish between those infants needing phototherapy and those infants where this treatment is not indicated.
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Mello, Rosane Reis de, Maria Virgínia Peixoto Dutra, José Roberto Ramos, Pedro Daltro, Márcia Boechat, and José Maria de Andrade Lopes. "Lung mechanics and high-resolution computed tomography of the chest in very low birth weight premature infants." Sao Paulo Medical Journal 121, no. 4 (2003): 167–72. http://dx.doi.org/10.1590/s1516-31802003000400006.
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CONTEXT: Premature infant lung development may be affected by lung injuries during the first few weeks of life. Lung injuries have been associated with changes in lung mechanics. OBJECTIVE: To evaluate an association between lung mechanics and lung structural alterations in very low birth weight infants (birth weight less than 1500 g). DESIGN: A cross-sectional evaluation of pulmonary mechanics (lung compliance and lung resistance) and high resolution computed tomography of the chest at the time of discharge, in 86 very low birth weight infants born at Instituto Fernandes Figueira, a tertiary public healthcare institution in Rio de Janeiro, Brazil. Lung compliance and resistance were measured during quiet sleep. High resolution computed tomography was performed using Pro Speed-S equipment. MAIN MEASUREMENTS: Statistical analysis was performed by means of variance analysis (ANOVA/ Kruskal Wallis). The significance level was set at 0.05. RESULTS: Abnormal values for both lung compliance and lung resistance were found in 34 babies (43%), whereas 20 (23.3%) had normal values for both lung compliance and lung resistance. The mean lung compliance and lung resistance for the group were respectively 1.30 ml/cm H2O/kg and 63.7 cm H2O/l/s. Lung alterations were found via high-resolution computed tomography in 62 (72%) infants. Most infants showed more than one abnormality, and these were described as ground glass opacity, parenchymal bands, atelectasis and bubble/cyst. The mean compliance values for infants with normal (1.49 ml/cm H2O/kg) high resolution computed tomography, 1 or 2 abnormalities (1.31 ml/cm H2O/kg) and 3 or more abnormalities (1.16 ml/cm H2O/kg) were significantly different (p = 0.015). Our data were insufficient to find any association between lung resistance and the number of alterations via high-resolution computed tomography. CONCLUSION: The results show high prevalence of lung functional and tomographic abnormalities in asymptomatic very low birth weight infants at the time of discharge. They also show an association between lung morphological and functional abnormalities.
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Majeed, Shahid, Samina Farooqi, Hafiz Safiullah Khattak, Sajid Rashid Nagra, Kamran Chaudhry, and Fayaz Ahmed Memon. "Prospective Evaluation of Auditory Brainstem Response against Hearing Loss Risk Factrs. A Clinical Based Study." Pakistan Journal of Medical and Health Sciences 16, no. 5 (May 30, 2022): 1132–34. http://dx.doi.org/10.53350/pjmhs221651132.
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Objective: The purpose of this study is to determine the improvement of auditory brainstem response against hearing loss risk factors among new born babies. Study Design: Prospective study Place and Duration: Bahawalpur Medical and Dental College, Bahawalpur and General Hospital, Lahore. Jan, 2021 to June, 2021 Methods: There were one hundred and thirty high risk infants were presented in this study. Birth weight and gestational age as well as transfusion and asphyxiation rates were documented once the parents provided written permission. Included patients had absent ABR or ABR thresholds ≥80 dBnHL. ABR testing during natural or chloral hydrate-induced sleep was part of the audiologist's examination. Patients with aberrant ABR responses underwent further testing, including optical absorption empiricism (OAE). Measurements of immittance were performed as necessary. All data was analyzed by using SPSS 22.0. Results: Among 130 cases, majority of the infants were males 85 (65.4%) and 45 (34.6%) infants were females. Mean gestational age of the infants was 35.11± 6.42 weeks. Mean weight of the infants was 1899.1± 2.654 grams. Frequency of severe birth asphyxia was seen in 65 (50%) cases. We found exchange transfusion in 25 (19.2%) cases. Improvement in ABR threshold was seen in 70 (53.8%) cases, partial improvement in 27 (20.8%) cases and no improvement was seen in 33 (25.4%) cases. After 3-4 months among patients of no/partial improvement, 42 (70%) patients were improved and no improvement was seen in 18 (30%) cases. Conclusion: We concluded in this study that the hearing loss can be improved in infants by early ear screening by using ABR thresholds. Re-screening of ABR thresholds provided better results among infants. Staged further hearing testing of babies is needed to monitor hearing development at an early age utilizing repeated ABR measures to identify hearing impairment and detect threshold changes crucial for treatment decision-making. Keywords: Infants, ABR thresholds, Improvement, OAE
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Komisarek, Oskar, Roksana Malak, Jacek Kwiatkowski, Katarzyna Wiecheć, Tomasz Szczapa, Joanna Kasperkowicz, Maja Matthews-Kozanecka, et al. "The Evaluation of Facial Muscles by Surface Electromyography in Very Preterm Infants." Biomedicines 10, no. 11 (November 14, 2022): 2921. http://dx.doi.org/10.3390/biomedicines10112921.
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Background: It is reported that 40% of preterm infants have problems with eating. Neonatal feeding disorders may be one of the factors increasing neonatal mortality. The aim of our study was to evaluate the muscles involved in suckling and swallowing in premature newborns using surface electromyography (sEMG). We would like to objectively describe the tension of muscles engaged in feeding in order to properly plan the therapy. Another aim was to compare sEMG measurements to gestational age, birth weight, and umbilical blood pH to show which parameters put children at risk of feeding problems. Methods: Sixteen preterm neonates with gestational age less than 32 weeks, birth weight less than 1500 g, and oral feeding difficulties were analyzed for muscle response and electrical activity of nerves using sEMG (surface electromyography). Results: We found a negative correlation indicating that preterm infants with a younger gestational age had higher suprahyoid muscle tension, and a positive correlation was found between pH value and suprahyoid muscles. The lower the pH value, the lower the tension in the suprahyoid muscles. Conclusions: sEMG may be a helpful diagnostic tool in the evaluation of the masticatory system of premature infants. Due to the abnormal tone of the muscles responsible for swallowing, it is advisable to rehabilitate as early as possible.
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Cowett, Richard, and Jeffrey Loughead. "Neonatal Glucose Metabolism: Differential Diagnoses, Evaluation, and Treatment of Hypoglycemia." Neonatal Network 21, no. 4 (June 2002): 9–19. http://dx.doi.org/10.1891/0730-0832.21.4.9.
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Hypoglycemia is one of the most common clinical care issues facing the neonatal practitioner. Increasing evidence indicates that neonatal hypoglycemia may have long-term neurologic effects. Care is complicated by the lack of a clearly defined threshold for hypoglycemia in term and preterm infants, however, and by highly variable clinical signs and symptoms. Furthermore, many infants with low blood glucose measurements do not exhibit obvious signs of impairment. The complexity of neonatal glucose metabolism is illustrated by the variety of conditions producing or associated with both neonatal hypo- and hyperglycemia. Maintenance of euglycemia is especially challenging in the sick or low birth weight neonate. This article defines euglycemia by its range and reviews the differential diagnoses and etiology of hypoglycemia—as well as the principles of its management—in the neonatal period.
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Crapanzano, Michael S., William B. Strong, Ingrid R. Newman, R. Lester Hixon, Devarra Casal, and Charles W. Linder. "Calf Blood Pressure: Clinical Implications and Correlations With Arm Blood Pressure in Infants and Young Children." Pediatrics 97, no. 2 (February 1, 1996): 220–24. http://dx.doi.org/10.1542/peds.97.2.220.
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Objective. Indirect measurement of lower extremity blood pressure is often used in the clinical setting, although normative data after the newborn period are not readily available. Methods. Indirect blood pressure (BP) measurement was obtained in the right arms and right calves of 148 healthy infants and young children 2 weeks to 3 years of age. All measurements were made using an oscillometric device. The infants and children were quiet or asleep and in the supine position. A BP cuff of proper size was chosen. Three measurements were made in both extremities; the average of the second and third measurements was used for all analyses. Results. Age correlated better with calf systolic blood pressure (SBPc) than with arm SBP (SBPa) (r = .52 vs .17). Calf diastolic blood pressure (DBPc) and calf mean blood pressure (MBPc) correlated moderately poorly with age (r = .37 and .39, respectively). There was no order effect. SBPc correlated best with height (r .53), then age (r = .52), and, finally, weight (r = .51). The correlation between BPc and BPa was moderately low. The correlation of SBPc with SBPa was r = .46; that of DBPc with DBPa was r = .37; and that of MBPc with MBPa was r = .41. From birth to 6 months, SBPc was slightly lower than SBPa (1 to 3 mm Hg). SBPc increased linearly relative to SBPa and began to exceed SBPa at 6 months of age. The pattern of DBP and MBP was similar. Wide variability of blood pressure parameters was noted between the infants and children at all ages. Conclusions. Reference data are presented for BPc and the difference between BPc and BPa in healthy infants and children from 2 weeks to 3 years of age. BPc is not equivalent to BPa and should not be arbitrarily substituted. Because of the wide variability among healthy infants and children, SBPc measurements should be interpreted with caution when evaluating for coarctation of the aorta.
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Mobini, Gholam Reza, Abbas Karimi, Abolfazl Akbari, and Forouzan Rahmani. "Evaluation of Teratogenic Activity of Antiepileptic Drug Lamotrigine in Mouse Fetuses." Folia Medica 61, no. 1 (March 1, 2019): 84–89. http://dx.doi.org/10.2478/folmed-2018-0058.
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Abstract Background: Use of antiepileptic drugs during pregnancy can be associated with an increased risk of teratogenicity as well as congenital abnormalities. However, there are numerous discrepancies to determine whether lamotrigine, as an antiepileptic drug, can significantly induce malformation in newborn infants or not. Thus, the purpose of the study was to evaluate the teratogenic effects of lamotrigine on mouse fetuses. Materials and methods: In the present study, 21 pregnant mice were assigned to four groups. Groups 1 and 2 (controls) received mock treatment and ethanol 20%, respectively. Groups 3 and 4 (treatment) were intraperitoneally administered with 25 and 75 mg/kg lamotrigine for three days, respectively. The treatment protocol was performed within the gestational days of 9-18 in all groups. On gestational day 18, 117 fetuses were taken out of the fallopian tube of studied mice and then examined for any anomalies (vertebral, limbs and cranial), followed by a measurement of their height and weight. Results: The results revealed that, in the treated groups, the weight and the height had significantly decreased (p<0.01) and also various anomalies were evident. Moreover, as the dose of lamotrigine increased, the decrease in the weight and the height and rising trend in anomalies were intensified. Conclusion: According to the findings, lamotrigine (LTG) could be considered as a risk factor for the development of the anomalies examined.
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Muhardi, Leilani, Leilani Muhardi, Eline M. Van der Beek, Marieke Abrahamse-Berkeveld, Hamid Jan B. Jan Mohamed, Ngee Lek, Wendy Oddy, and V. P. Wickramasinghe. "Early detection of childhood obesity through extended routine growth monitoring of children below two years of age in the Asia Pacific region." World Nutrition Journal 2, no. 1 (August 23, 2018): 22. http://dx.doi.org/10.25220/wnj.v02.i1.0004.
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Introduction Increased body fat deposition during early life predisposes to higher obesity and metabolic disorder risks in later life. This is particularly relevant in the Asia Pacific region where historically prevalent under-nutrition is now been paralleled or even overruled by over-nutrition over the last few decades. This overview aims to evaluate the potential of early detection of obesity (risk) among experts through addition of specific growth monitoring assessments in children during the first two years of life. Methods A discussion among experts from Malaysia, Singapore, Sri Lanka and Australia on infant growth and a qualitative evaluation of current practice highlighted the need to measure body composition to assess the quality of growth. Current tools are mainly directed towards simple anthropometric measures such as body weight, length and head circumference which do not adequately reflect concurrent changes in body composition to detect early life adiposity development. Recent findings have shown benefits of measurement such as the sum of four skinfold thickness (S4SFT) during the first two years of life for risk assessment of later overweight/obesity. We recommend this assessment for routine practice as a proxy for fat deposition in young children. Further studies to understand implementation hurdles and cost-effectiveness of S4SFT and health outcomes in young children in the Asia Pacific region are necessary. Conclusion Inclusion of four skinfold thickness measurements as part of routine growth monitoring assessment, in addition to weight and height, could be recommended to assess adiposity development in early life allowing identification of infants at risk for obesity.
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Chharra, Samia, and Saira Khan. "Nutritional Status by Anthropometric Evaluation of Infants Suffering From Neonatal Cholestasis Attending Department of Paediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh." Scholars Journal of Applied Medical Sciences 10, no. 5 (May 24, 2022): 828–35. http://dx.doi.org/10.36347/sjams.2022.v10i05.026.
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Background: Neonatal cholestasis is an uncommon but potentially serious condition that indicates hepatobiliary dysfunction. Nutritional deficiencies are common in infants with any chronic hepatitis diseases, especially when cholestasis is present and its onset occurs in the first of life. It is important to assess nutritional status in infant with neonatal cholestasis for nutritional intervention and better prognosis. However very few organized effort has been made to evaluate the nutritional status of infants with neonatal cholestasis. Objective: To observe the nutritional status by anthropometric evaluation of infants suffering from neonatal cholestasis attending department of Paediatric Gastroenterology and Nutrition, BSMMU. Study design: Cross-sectional observational study. Study setting and period: This study was conducted in department of Paediatric Gastroenterology and Nutrition, BSMMU, during 6 month period from April, 2013 to September, 2013. Study population: Eighty infants of neonatal cholestasis attending in department of Paediatric Gastroenterology and Nutrition, BSMMU, who developed conjugated hyperbilirubinemia (appears before or beyond 14 days and progress after this time or does not resolve at this time but appears within 3 months of age) were included in this study. Methods: All data were recorded in a specially designed semi structured questionnaire form. All patients with symptoms of neonatal cholestasis (jaundice, pale stool and dark urine) who attended the department of paediatric gastroenterology and nutrition, BSMMU, Dhaka, Bangladesh were enrolled for the study. Detailed history taking and physical examination including anthropometric measurements of all these patients were done and recorded by researcher herself. The assessment included weight (W) and length (L). Nutritional status were determined from the Z score (Z) for the following indices: W/A, LA, W/L and using reference values from the World Health organization (WHO). ...............
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Ariyuki, Yasuhide, Toshiyuki Hata, and Manabu Kitao. "Evaluation of Perinatal Outcome Using Individualized Growth Assessment: Comparison With Conventional Methods." Pediatrics 96, no. 1 (July 1, 1995): 36–42. http://dx.doi.org/10.1542/peds.96.1.36.
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Objective. To evaluate individualized growth assessment using the Rossavik growth model for detection of growth-retarded neonates with poor perinatal outcomes. Methods. Rossavik growth models derived from second-trimester ultrasound measurements were used to predict birth characteristics of 154 singleton neonates. Individual fetal growth curve standards for head and abdominal circumference and weight were determined from the data of two scans obtained before 25 weeks' menstrual age and separated by an interval of at least 5 weeks. Comparisons between actual and predicted birth characteristics were expressed by the Growth Potential Realization Index and the Neonatal Growth Assessment Score (NGAS). The proportions of perinatal outcomes (mechanical delivery, low Apgar score, abnormal fetal heart rate [FHR] patterns, neonatal acidosis, meconium staining of amniotic fluid, neonatal intensive care unit admission, and maternal complications), using NGAS, were compared with those by the traditional birth weight-for-gestational age method and the ponderal index, respectively. Results. Of the 154 fetuses studied, 120 had normal growth outcomes at birth; 18 showed evidence of intrauterine growth retardation; and 16 had macrosomia, based on NGAS. According to birth weight-for-gestational age classification, 32 fetuses were small for gestational age; 118 were appropriate for gestational age; and only 4 were large for gestational age. According to the ponderal index, 55 fetuses had growth retardation, 99 showed appropriate growth and there was no macrosomia. There was a significant increase in mechanical deliveries in cases of growth-retarded neonates, determined using the NGAS classification, when compared with events related to normally grown or macrosomic neonates. However, there were no significant differences in mechanical deliveries among the groups by birth weight classification or ponderal index. Both birth weight classification and NGAS classification showed a significant increase in the low Apgar score, abnormal FHR patterns, and neonatal acidosis in infants classified as growth retarded when compared with appropriately grown or macrosomic infants. However, there were no significant differences in the low Apgar score, abnormal FHR patterns, and neonatal acidosis between growth-retarded and appropriately grown infants when they had been so classified by ponderal index. Three growth category classification methods failed to reveal significant differences in meconium staining of amniotic fluid, neonatal intensive care unit admission, and maternal complications among the groups. Conclusion. We do cast doubt on the usefulness of the ponderal index for detection of growth-retarded neonates with poor perinatal outcomes, and individualized growth assessment seems to perform at least as well as the traditional birth weight-for-gestational age method.
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Pahlevanynejad, Shahrbanoo, Navid Danaei, and Reza Safdari. "Design, implementation, and evaluation of an innovative intelligence information management system for premature infants." DIGITAL HEALTH 8 (January 2022): 205520762211277. http://dx.doi.org/10.1177/20552076221127776.
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Introduction Low birth weight is the most important condition of neonatal community health and the main cause of neonates' mortality. Identifying the indexes associated with this condition, and factors to prevent, and managing related data can help reduce the birth of premature infants to reduce the mortality rate due to this condition. The goal of present study was to design, implement and evaluate an innovative intelligence information management system for premature infants. Material and method The present study was a multidisciplinary research that was done in 2019 to 2021 in four integrated phases in Iran. The first phase aimed to compare the current status of registration systems of premature infants through a systematic review and semi-structured interviews by using the Delphi model Then the minimum data set was determined and was designed a proposed model based on it. In the second phase, the structure and how the user interacts with the system were determined, and, using Microsoft Visio software, Unified Modeling Language diagrams were drawn to define the logical relationship of data. In the third phase, the system was developed, and finally in the last phase, in three methods, users' views on the usability of the system were evaluated. Results The findings of this study included 233 essential data elements that were placed in two main groups of essential data, and the system was approved by end users for 87.73% consent and 67.19% satisfaction for SUMI (Software Usability Measurement Inventory) and 7.97 of 9 in QUIS questionnaire. Conclusion This research's results can be beneficial and functional such as a complete sample for design and development of other systems concerned to health systems.
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Connor, Jean, Lauren Hartwell, Jennifer Baird, Benjamin Cerrato, Araz Chiloyan, Courtney Porter, and Patricia Hickey. "Nurse-Sensitive Quality Metrics to Benchmark in Pediatric Cardiovascular Care." American Journal of Critical Care 29, no. 6 (November 1, 2020): 468–78. http://dx.doi.org/10.4037/ajcc2020884.
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Background Associations between the quality of nursing care and patient outcomes have been demonstrated globally. However, translation and application of this evidence to robust measurement in pediatric specialty nursing care has been limited. Objectives To test the feasibility and performance of nurse-sensitive measures in pediatric cardiovascular programs. Methods Ten nurse-sensitive measures targeting nursing workforce, care process, and patient outcomes were implemented, and measurement data were collected for 6 months across 9 children’s hospitals in the Consortium of Congenital Cardiac Care–Measurement of Nursing Practice (C4-MNP). Participating sites evaluated the feasibility of collecting data and the usability of the data. Results Variations in nursing workforce characteristics were reported across sites, including proportion of registered nurses with 0 to 2 years of experience, nursing education, and nursing certification. Clinical measurement data on weight gain in infants who have undergone cardiac surgery, unplanned transfer to the cardiac intensive care unit, and pain management highlighted opportunities for improvement in care processes. Overall, each measure received a score of 75% or greater in feasibility and usability. Conclusions Collaborative evaluation of measurement performance, feasibility, and usability provided important information for continued refinement of the measures, development of systems to support data collection, and selection of benchmarks across C4-MNP. Results supported the development of target benchmarks for C4-MNP sites to compare performance, share best practices for improving the quality of pediatric cardiovascular nursing care, and inform nurse staffing models.
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Wielenga, J., R. De Vos, R. de Leeuw, and R. De Haan. "Comfort Scale: A Reliable and Valid Method to Measure the Amount of Stress of Ventilated Preterm Infants." Neonatal Network 23, no. 2 (March 2004): 39–44. http://dx.doi.org/10.1891/0730-0832.23.2.39.
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Objective: Assessment of clinimetric properties and diagnostic quality of a stress measurement scale (COMFORT scale).Design: Sample of an open population.Setting: Neonatology department (Neonatal Intensive Care Unit), Academic Medical Centre/Emma Children’s Hospital, Amsterdam, the Netherlands.Method: One clinical expert and 9 observers observed ventilated premature born babies simultaneously. Criterion validity was assessed by correlating the COMFORT scale with the clinical judgment regarding the amount of stress. Interobserver reliability was assessed on the clinical judgment as well as on the COMFORT scale. Diagnostic qualities were evaluated with a ROC curve.Results: On 19 ventilated prematurely born babies (mean gestational age 30 weeks, mean birth weight 1385 gm), one clinical expert and 9 observers made 30 paired observations. The criterion validity of the COMFORT scale was good (Pearson’s r of 0.84). The interobserver reliability of the clinical judgment was very good (weighted Kappa 0.84). The interobserver reliability of each item varied from good to almost perfect (weighted Kappa of 0.64 for muscle tone to 1.00 on heart rate). The reliability of the total COMFORT scale score was satisfying (intraclass correlation coefficient of 0.94). The diagnostic quality of the COMFORT scale was excellent, at a cut-off point of 20 the sensitivity was 100 percent, the specificity was 77 percent, and the area under the curve (AUC) of 0.95.Conclusion: In this first evaluation, the COMFORT scale appears to be a valid and reliable measurement tool to assess the stress of ventilated prematurely born babies.
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Kılıç, Kubilay Doğan. "Liver Histology and Biochemistry of Exposed Newborn and Infant Rats with Experimental Aflatoxicosis." Pakistan Veterinary Journal 42, no. 04 (October 1, 2022): 453–60. http://dx.doi.org/10.29261/pakvetj/2022.066.
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Gestational and lactational transmission of Aflatoxin B1 (AFB1) can elicit several toxic effects emphasizing the severity of aflatoxicosis. The present study aimed to investigate the genotoxic effects of prenatal and postnatal exposure to AFB1 on the livers of exposed offspring. With this aim, 50 μg/kg/body weight per day AFB1 was administered intraperitoneally (i.p.) to pregnant and lactating dam rats. Pups grouped as newborns (GD21/PND0) exposed in utero and infants exposed through breast milk (PND21) were compared with body weight measurements. Liver tissues were weighed after removal and subjected to histochemical (HC), immunohistochemical (IHC) and biochemical analyzes. The body weight and liver weight of exposed newborns were significantly lower than control (P<0.05). The histomorphological changes were more pronounced in exposed newborns. A decrease (P<0.05) in the histological score (HSCORE) of cytokeratin 19 (CK19) IHC, fetal stem/progenitor cells marker, and an increase (P<0.05) in the HSCORE of alpha-fetoprotein (AFP) IHC, hepatocellular carcinoma (HCC) marker, were detected in both exposed groups. Exposed newborns showed higher CK19 and AFP HSCORE than exposed infants (P<0.05). Both groups exhibited a low proliferation index score of proliferating cell nuclear antigen (PCNA) IHC (P<0.05). The high apoptotic index score of immunofluorescence (IF) staining of the terminal deoxytransferase-mediated dUTP nick-end labeling (TUNEL) method was significant in exposed newborns (P<0.05). Evaluation of oxidative stress and antioxidant systems revealed that tissue malondialdehyde (MDA) levels decreased in exposed newborns and increased in exposed infants (P<0.05), and tissue catalase (CAT) levels increased in both groups (P<0.05). In conclusion, the effects of AFB1 exposure during the gestational period occurred more severely, and the importance of preventing AFB1 exposure was revealed
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Hwang, Joon Ho, Yong-Hak Sohn, Seong-Sil Chang, and Seung Yeon Kim. "Evaluation of three glucometers for whole blood glucose measurements at the point of care in preterm or low-birth-weight infants." Korean Journal of Pediatrics 58, no. 8 (2015): 301. http://dx.doi.org/10.3345/kjp.2015.58.8.301.
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Jiménez Corona, Azucena Eunice, Cinthia Yarely De la Cruz Hernández, Gilberto Hernández Hernández, and Luis Rey Martínez Santos. "Evaluation of the nutritional status of adolescents enrolled in the General High School from the Superior School of Huejutla, UAEH." Mexican Journal of Medical Research ICSA 8, no. 16 (July 5, 2020): 27–32. http://dx.doi.org/10.29057/mjmr.v8i16.4744.
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Nowadays, one of the main public health concerns worldwide is overweight and obesity; in addition, this event has developed significant damage in the pediatric population (infants, children and adolescents). Therefore, it is well known that the reason is an energy disproportion between the calories consumed and spent. Furthermore, the aim study was to anthropometrically assess the current health condition and the degree of overweight and obesity in young subjects between 14 and 17 years of age from the General High School from the Superior School of Huejutla, the Autonomous University of State of Hidalgo. The project was realized in a sample of teenagers (N = 99), conventional anthropometric measurements were engaged such as: height, weight, abdomen circumference, arm circumference. The size in percentiles according to the BMI of the tables of growth and development curves (CDC) was used: poor (<5 percentile), lean (5 <95th percentile), overweight (85 <95th percentile) and obesity (> 95th percentile). Moreover, the systolic and diastolic blood pressure of each of the subjects in the sample was measured in triplicate. The results obtained were subdivided into low weight (6.6%) normal weight (71.71%), overweight (18.18%) and obesity (37.14%) according to the BMI. In this way, they were grouped according to percentiles in: normal pressure (4.4%), prehypertension (12.12%) and hypertension (5.05%). An isolated result was gained in the prevalence of nutritional states of risk of overweight and obesity. Nevertheless, the trend in this population is weight gain.
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Hurley, Kristen M., John Phuka, Yunhee Kang, Julie Ruel-Bergeron, Audrey J. Buckland, Maithilee Mitra, Lee Wu, Rolf D. W. Klemm, Keith P. West, and Parul Christian. "A longitudinal impact evaluation of a comprehensive nutrition program for reducing stunting among children aged 6–23 months in rural Malawi." American Journal of Clinical Nutrition 114, no. 1 (March 19, 2021): 248–56. http://dx.doi.org/10.1093/ajcn/nqab010.
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ABSTRACT Background Growth failure in sub-Saharan Africa leads to a high prevalence of child stunting starting in infancy, and is attributed to dietary inadequacy, poor hygiene, and morbidity. Objectives To evaluate the impact of a program in Malawi providing a lipid-based nutrient supplement to infants from 6–23 months of age, accompanied by a social and behavior change communication intervention to optimize caregiver feeding and handwashing practices. Methods This impact evaluation was a quasi-experimental, longitudinal study with 1 program and 1 comparison district. Infants were enrolled at 6–7 months of age. Anthropometry, child morbidity, and caregiver feeding and handwashing practices were assessed at enrollment and at 6, 12, and 18 month follow-ups (ages 6, 12, 18, and 24 months, respectively). Changes in the length-for-age z-score (LAZ), weight-for-length z-score (WLZ), and midupper arm circumference (MUAC) were compared using mixed-effects models. Program impacts on child stunting (LAZ < −2), wasting (WLZ < −2), morbidity, and feeding and handwashing practices were estimated using difference-in-differences. Results We enrolled 367 infants across the program (n = 176) and comparison (n = 191) districts. The combined prevalences of stunting and wasting at enrollment were 42.1% and 1.4%, respectively, and did not differ by district. At enrollment, the prevalence of severe stunting (LAZ < −3) was higher in the program (15.5%) versus comparison (7.6%) district (P = 0.02), with corresponding lower LAZ scores (−1.9 vs. −1.7, respectively; P = 0.12). Growth velocities favored program children, such that LAZ, WLZ, and MUAC measurements increased by +0.12/y (P = 0.06), +0.12/y (P = 0.04), and +0.24 cm/y (P < 0.001), respectively, leading to comparable LAZ distributions across districts by 24 months of age. Program exposure was associated with 19.8 percentage point (pp) and 13.8 pp reductions in the prevalences of malaria (P = 0.001) and fever (P = 0.02), respectively, at the 18-month follow-up. Improvements of 20 pp (P < 0.01) in minimum dietary diversity and minimum acceptable diet were seen in the program versus comparison district at 18 months of follow-up. Conclusions The program improved child growth patterns, with benefits to health and diet apparent after 18 months of exposure. This trial was registered at clinicaltrials.gov as NCT02985359.
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Gire, Catherine, Noémie Resseguier, Véronique Brévaut-Malaty, Stéphane Marret, Gilles Cambonie, Isabelle Souksi-Medioni, Jean-Baptiste Müller, et al. "Quality of life of extremely preterm school-age children without major handicap: a cross-sectional observational study." Archives of Disease in Childhood 104, no. 4 (June 30, 2018): 333–39. http://dx.doi.org/10.1136/archdischild-2018-315046.
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ObjectiveTo determine the quality of life (QoL) of school-aged children who were born <28+0 weeks of gestation and who have no resultant major disabilities.Design, setting and patientsA cross-sectional multicentre study of extremely preterm (EPT) infants born <28+0 weeks, discharged alive and free from severe impairments (cerebral palsy, autism, major cognitive disabilities). Two generic, self-evaluation and hetero-evaluation (by parent) QoL measurement questionnaires (Kidscreen 10/VSP-A) were used and then compared with French population reference.Main outcome measuresClinical examination, an assessment of cognitive functions and QoL between 7 and 10 years of age.Results40 (7.5%) severely disabled children were excluded. Among those 471 eligible, the lost to follow-up group (169 (36%)) paralleled those 302 (64%) included in the study. The mean gestational age was 26.2 (±0.8), birth weight was 879 (±181) g and the mean age was 8.4 (±0.87) years. 48% of participants had minor or moderate cognitive disabilities based on their Full-Scale Index Quotient. Working memory, attention and mental flexibility scored as low-average. Except for family relationships, the EPT QoL VSP-A and Kidscreen 10 assessment were significantly lower based on the children’s and parent’s perspectives. Children reported the most significant QoL decline as (1) friends’ relationships, (2) self-esteem and (3) leisure, while parents indicated (1) psychological well-being, (2) schoolwork and (3) vitality.ConclusionThe QoL of a school-age EPT child without severe impairment was lower relative to a reference population from both the parents’ and child’s points of view. This evaluation should help to better understand the long-term outcomes and to provide better support for them and their families.Trial registration numberNCT01675726, pre-results.
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Ingram, Martha-Conley E., Anna L. Huguenard, Brandon A. Miller, and Joshua J. Chern. "Poor correlation between head circumference and cranial ultrasound findings in premature infants with intraventricular hemorrhage." Journal of Neurosurgery: Pediatrics 14, no. 2 (August 2014): 184–89. http://dx.doi.org/10.3171/2014.5.peds13602.
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Object Intraventricular hemorrhage (IVH) is the most common cause of hydrocephalus in the pediatric population and is particularly common in preterm infants. The decision to place a ventriculoperitoneal shunt or ventricular access device is based on physical examination findings and radiographic imaging. The authors undertook this study to determine if head circumference (HC) measurements correlated with the Evans ratio (ER) and if changes in ventricular size could be detected by HC measurements. Methods All cranial ultrasound (CUS) reports at the authors' institution between 2008 and 2011 were queried for terms related to hydrocephalus and IVH, from which a patient cohort was determined. A review of radiology reports, HC measurements, operative interventions, and significant clinical events was performed for each patient in the study. Additional radiographic measurements, such as an ER, were calculated by the authors. Significance was set at a statistical threshold of p < 0.05 for this study. Results One hundred forty-four patients were studied, of which 45 (31%) underwent CSF diversion. The mean gestational age and birth weight did not differ between patients who did and those who did not undergo CSF diversion. The CSF diversion procedures were reserved almost entirely for patients with IVH categorized as Grade III or IV. Both initial ER and HC were significantly larger for patients who underwent CSF diversion. The average ER and HC at presentation were 0.59 and 28.2 cm, respectively, for patients undergoing CSF diversion, and 0.34 and 25.2 cm for those who did not undergo CSF diversion. There was poor correlation between ER and HC measurements regardless of gestational age (r = 0.13). Additionally, increasing HC was not found to correlate with increasing ERs on consecutive CUSs (φ = −0.01, p = 0.90). Patients who underwent CSF diversion after being followed with multiple CUSs (10 of 45 patients) presented with smaller ERs and HC than those who underwent CSF diversion after a single CUS. Just prior to CSF diversion surgery, the patients who received multiple CUSs had ERs, but not HC measurements, that were similar to those in patients who underwent CSF diversion after a single CUS. Conclusions The HC measurement does not correlate with the ER or with changes in ER and therefore does not appear to be an adequate surrogate for serial CUSs. In patients who are followed for longer periods of time before CSF shunting procedures, the ER may play a larger role in the decision to proceed with surgery. Clinicians should be aware that the ER and HC are not surrogates for one another and may reflect different pathological processes. Future studies that take into account other physical examination findings and long-term clinical outcomes will aid in developing standardized protocols for evaluating preterm infants for ventriculoperitoneal shunt or ventricular access device placement.
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de Oliveira Tobinaga, Welcy Cassiano, Cirlene de Lima Marinho, Vera Lucia Barros Abelenda, Paula Morisco de Sá, and Agnaldo José Lopes. "Short-Term Effects of Hydrokinesiotherapy in Hospitalized Preterm Newborns." Rehabilitation Research and Practice 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/9285056.
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Background. In the neonatal intensive care unit (NICU) environment, preterm newborns are subject to environmental stress and numerous painful interventions. It is known that hydrokinesiotherapy promotes comfort and reduces stress because of the physiological properties of water.Objective. To evaluate the short-term effects of hydrokinesiotherapy on reducing stress in preterm newborns admitted to the NICU.Materials and Methods. Fifteen preterm newborns underwent salivary cortisol measurement, pain evaluation using the Neonatal Infant Pain Scale (NIPS), and heart rate, respiratory rate, and peripheral oxygen saturation measurements before and after the application of hydrokinesiotherapy.Results. The mean gestational age of the newborns was34.2±1.66weeks, and the mean weight was1823.3±437.4 g. Immediately after application of hydrokinesiotherapy, a significant reduction was observed in salivary cortisol(p=0.004), heart rate(p=0.003), and respiratory rate(p=0.004)and a significant increase was observed in peripheral oxygen saturation(p=0.002). However, no significant difference was observed in the NIPS score(p>0.05).Conclusion. In the present study, neonatal hydrotherapy promoted short-term relief from feelings of stress. Neonatal hydrokinesiotherapy may be a therapeutic alternative. However, this therapy needs to be studied in randomized, crossover, and blinded trials. This trial is registered withNCT02707731.
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Setiyorini, Erni, and Yeni Kartika Sari. "Cadres Empowerment in the Application, Socialization Early Detection of Development Children and Anticipatory Guidance in Wonodadi District." Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) 2, no. 3 (August 1, 2015): 270–75. http://dx.doi.org/10.26699/jnk.v2i3.art.p270-275.
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In Indonesia, the number of infants reach 10% of the population, in which the prevalence ofdevelopment disorder 12,8%–16% and we need to screening development of children. The mortality ofchildrens high due to accident, poisoning and trauma recorded 7,3% and one of top five lead childdeaths in 1992. Based on interviews with some kader posyandu, we know that the kader had neverreceived training related to early detection growth and development and anticipatory guidance inchildren. The purpose of this science and technology activity for society was to empower kader in theapplication, the socialization of children’s early detection growing and development Method for thisactivity was to team up with 2 partners i.e. Midwife of Kebonagung Village with number of kader of 25people and the midwife of Wonodadi village with number of cadres of as many as 30 people. The methodof this activity was to provide a pre test training before, children’s early detection growth and developmentwith method of lecture, discussion, simulation and applications of valuation DDTK in kindergarten,mentoring and evaluation of training activities and the activities of the posyandu. The results of theevaluation of the training process showed improved knowledge on average level of good on both ofkader and partner, most cadres is skilled, whereas the evaluation of the activities of mentoring atposyandu activities, most of posyandu already documenting the measurement of height, weight, nutritionalstatus, while for childrens’s early detection growing and development with developmental screeningassessment card but not complete. In order for the assessment, documentation, socialization ofchildrens’s early detection growing and development activities and anticipatory guidance fluently,then the expected partner, the Councilor and head of the Clinic Wonodadi made a commitment in themonitoring activities.
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Rüffer, André, Ferdinand Knieling, Robert Cesnjevar, Adrian Regensburger, Ariawan Purbojo, Sven Dittrich, Frank Münch, Joachim Wölfle, and Jörg Jüngert. "Equal cerebral perfusion during extended aortic coarctation repair." European Journal of Cardio-Thoracic Surgery 61, no. 2 (October 29, 2021): 299–306. http://dx.doi.org/10.1093/ejcts/ezab415.
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Abstract OBJECTIVES Aortic coarctation with distal aortic arch hypoplasia can be effectively addressed by coarctation resection with extended end-to-end-anastomosis (REEEA). Particularly, when unilateral cerebral perfusion (UCP) is established by clamping of left-sided supra-aortic vessels, the extent of cerebral blood flow distribution during repair remains undetermined, so far. Transfontanellar contrast-enhanced ultrasound (T-CEUS) can be utilized for real-time visualization and quantitative evaluation of cerebral blood flow. This study quantitatively evaluates cerebral perfusion during REEEA by using intraoperative T-CEUS. METHODS In a prospective study, 9 infants with open fontanelle undergoing REEEA [median age: 13 days (range 1–34) and median weight 3.1 kg (range 2.2–4.4)] were intraoperatively examined with T-CEUS at 3 consecutive time-points: before skin incision, during UCP and after skin suture. A software-based analysis of 11 parameters was used for data evaluation. Absolute and relative blood flow in contralateral hemispheres was measured in side-by-side comparison, and referenced to baseline measurements. RESULTS No side-depend absolute or relative cerebral perfusion differences were found during REEEA, except for an increased relative ‘wash-out-rate’ (P = 0.0013) in favour of the right hemisphere after surgery. Compared to ipsilateral baseline levels, ‘rise time’ was transiently increased in right (P = 0.0277) and ‘time-to-peak’ in both hemispheres (right: P = 0.0403 and left: P = 0.0286), all during UCP. CONCLUSIONS The use of T-CEUS provided evidence for homogenous distribution of contrast agent in both hemispheres during UCP. T-CEUS can be utilized for the postprocedural evaluation of cerebral perfusion during congenital cardiac surgery. Clinical Trial Registration URL: http://www.clinicaltrials.gov Unique, Identifier: NCT03215628.
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Niokhor, Diouf Francois, Diallo Fatima Bintou, Thiam Lamine, Kane Yaya, Ba Idrissa Demba, Ba Abouba, Faye Pape Mactar, Ndiaye Ousmane, Gueye Modou, and Diagne Ndeye Ramatoulaye. "Evaluation De La Prematurite Superieure Ou Egale A 32 Semaine D’amenorhée A L’hopital Regional De Ziguinchor Au Sud Du Senegal (Afrique De L’ouest)." European Scientific Journal, ESJ 13, no. 36 (December 31, 2017): 325. http://dx.doi.org/10.19044/esj.2017.v13n36p325.
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Introduction: Prematurity is one of the leading causes of neonatal death in Africa. The objective of this work was to assess the preterm birth at the pediatric service of the regional hospital of Ziguinchor. Material and methods: This was a prospective, descriptive and analytical study of the case of hospitalized newborns whose age was between 32 SA to 36SA + 6 days. The study was conducted from May 21, 2013 to May 21, 2014. We included all premature infants at age ≥ 32SA.Those presenting a malformation were not included. We studied maternal socio-demographic, obstetric and neonatal parameters. Results: We have identified 140 newborns out of a total of 342 Preterm births and 2292 maternity births, a prevalence of 40.9% compared to preterm infants and 6.10% in relation to all births. 51.4 percent of mothers came from urban areas, 63.5 percent were between 20 and 34 years of age, not attending school in 45.7 percent, married in 72.9 percent and without work in 94.3 percent. The average gestures represented 3.09 . Arterial hypertension was the most common medical condition (67.7%). The followup was done by a midwife (82.1%) and 23.5% had received at least 4 NPC. Eclampsia and pre-eclampsia (48.9%) and RPM (42.8%) were common obstetric pathologies. The delivery was by caesarian (51.4%), hospital (92.1%), cephalic presentation (80%), with an average weight of 1816.79 g. An RCIU (16.4%), an RPM (61.9%). At birth, a DR (16.4%) was noted due to MMH (43.7%) and transitory tachypnea (50%). Asphyxia was reported in 3.5%. During hospitalization (6.7 days on average), 6.4% had RD caused by infection (77.7%). Other complications were infection (64.4%), hypoglycemia (28.5%), digestive hemorrhage (7.01%). The fatality rate was 7.9% due to infection (63.3%), DR (18%), haemorrhage (9%). The anthropometric measurements at the exit: P 1887.9g, T: 38.3cm, PC: 30.9cm; at 1 month P: 2387.1g, T: 46.6cm, PC: 32.8cm; at 30 months P: 12.1kg, T: 89.5cm, PC: 48.4cm. Conclusion: Moderate preterm birth accounts for almost half of the cases of prematurity in our series. Their optimal management would go through a better obstetric-neonatal collaboration but above all by the installation of kangaroo mother units
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Anastasovska, Violeta, and Mirjana Kocova. "Newborn Screening for Thyroid-stimulating Hormone as an Indicator for Assessment of Iodine Status in the Republic of Macedonia." Journal of Medical Biochemistry 35, no. 4 (October 1, 2016): 385–89. http://dx.doi.org/10.1515/jomb-2016-0023.
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SummaryBackground:Iodine deficiency is associated with goiter and impaired brain function leading to cretinism. An increased frequency of thyroid-stimulating hormone (TSH) measurements above 5 mIU/L on newborn screening points toward an impaired iodine status of the population.Methods:A 13-year retrospective analysis was performed in 228,266 newborns participating in the national thyroid newborn screening program. The TSH concentration was measured in dry blood spots collected by heel stick on filter paper, 48 hours after birth, using fluoroimmunometric DELFIA method.Results:Out of 236,378 live-born infants, 228,266 (96.6%) have been screened for TSH, of which 198,213 (86.8%) were retrospectively evaluated for TSH levels above 5 mIU/L. Neonates with congenital hypothyroidism, prematurity, and low birth weight were excluded from the evaluation, as well as the inadequately sampled neonates (13.2%). A national prevalence of 3.08% newborns (n=6,105) with TSH > 5 mIU/L was found. Higher percentages were noted in two regions of the country, indicating possible mild iodine deficiency in these regions and shifting the overall average to above 3%.Conclusions:Our results indicate overall iodine sufficiency in the Macedonian population. Additional assessment of the iodine intake in the regions with suspected mild iodine deficiency is needed to prevent suboptimal cognitive and psychomotor outcomes.
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Javier Puppo Castro, Carlos, and Enrique Omar Guadarrama Diaz. "CORRELATION OF THE PROTEIN DETERMINATION IN 24-HOUR URINE WITH THE PROTEIN / CREATININE INDEX IN PEDIATRIC PATIENTS WHO GO TO THE EXTERNAL CONSULTATION OF THE PEDIATRIC NEPHROLOGY SERVICE AT THE NAVAL MEDICAL CENTER." International Journal of Advanced Research 9, no. 06 (June 30, 2021): 743–50. http://dx.doi.org/10.21474/ijar01/13071.
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Introduction : Proteinuria increases infant morbidity and mortality, constituting a risk for the development of chronic kidney disease. Medical follow-up is necessary to monitor kidney function, as well as to prevent long-term deterioration of kidney function. Proteinuria can be benign or a serious systemic disorder, the one that is persistent accelerates the decrease in the glomerular filtration rate and key in the progression of kidney diseases. There are various ways of measuring urinary proteins, between the protein / creatinine index and in 24-hour urine, which present a variable correlation according to what is described in the literature. Objective: To determine the correlation of 24-hour protein and protein / creatinine index in pediatric patients who attend the outpatient clinic of the pediatric nephrology service at the Naval Medical Center. Material and methods : Descriptive cross-sectional study. Performed in the Pediatric service and Pediatric Nephrology outpatient service at the Naval Medical Center. Study population: Children with a history of proteinuria treated by the Pediatric Nephrology service at the Naval Medical Center. General description of the study : The patients were selected from the electronic file that they attended the Pediatric Nephrology service. In the clinical evaluation, weight and height were taken, and a physical examination was performed, as well as a 24-hour protein determination in 24-hour urine, 24-hour creatinine clearance in urine in addition to creatinine and proteins in isolated urine. Statistical analysis : Descriptive statistics were performed, according to the measurement scale of the variables and the correlation between the variables was determined using the Spearman or Pearson test according to the type of distribution of the quantitative variables. Results : 107 were included. Taking into account the 24-hour urine collection protein measurement, only 4 patients (7.4%) had proteinuria in nephrotic ranges and for the CPI measurement only in 3 (5.6%). With both measurement methods, the same proportion of significant proteinuria was observed, corresponding to 13 patients (24.1%), obtaining in the first case a spearman correlation coefficient of r = 0.752, p = 0.000, and for the second an r = 0.911, p: 0.000. Conclusions: The protein / creatinine index had a positive correlation with 24-hour proteinuria in those pediatric patients who presented abnormal results in urine studies and kidney stones (32%), chronic kidney disease and kidney transplantation (18%) and obesity / overweight. Likewise it allows to establish a directly proportional association. There is a positive correlation between the protein / creatinine index and the quantification of proteinuria in 24 hours after adjusting for creatinine per kilogram of weight. And the protein / creatinine ratio is a good candidate for the diagnosis of chronic kidney disease in pediatric patients and its use is justified.
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Kermorvant-Duchemin, Elsa, Guylène Le Meur, Frank Plaisant, Laetitia Marchand-Martin, Cyril Flamant, Raphaël Porcher, Alexandre Lapillonne, et al. "Thresholds of glycemia, insulin therapy, and risk for severe retinopathy in premature infants: A cohort study." PLOS Medicine 17, no. 12 (December 11, 2020): e1003477. http://dx.doi.org/10.1371/journal.pmed.1003477.
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Background Hyperglycemia in preterm infants may be associated with severe retinopathy of prematurity (ROP) and other morbidities. However, it is uncertain which concentration of blood glucose is associated with increased risk of tissue damage, with little consensus on the cutoff level to treat hyperglycemia. The objective of our study was to examine the association between hyperglycemia and severe ROP in premature infants. Methods and findings In 2 independent, monocentric cohorts of preterm infants born at <30 weeks’ gestation (Nantes University Hospital, 2006–2016, primary, and Lyon-HFME University Hospital, 2009–2017, validation), we first analyzed the association between severe (stage 3 or higher) ROP and 2 markers of glucose exposure between birth and day 21—maximum value of glycemia (MaxGly1–21) and mean of daily maximum values of glycemia (MeanMaxGly1–21)—using logistic regression models. In both the primary (n = 863 infants, mean gestational age 27.5 ± 1.4 weeks, boys 52.5%; 38 with severe ROP; 54,083 glucose measurements) and the validation cohort (n = 316 infants, mean gestational age 27.4 ± 1.4 weeks, boys 51.3%), MaxGly1–21 and MeanMaxGly1–21 were significantly associated with an increased risk of severe ROP: odds ratio (OR) 1.21 (95% CI 1.14–1.27, p < 0.001) and OR 1.70 (95% CI 1.48–1.94, p < 0.001), respectively, in the primary cohort and OR 1.17 (95% CI 1.05–1.32, p = 0.008) and OR 1.53 (95% CI 1.20–1.95, p < 0.001), respectively, in the validation cohort. These associations remained significant after adjustment for confounders in both cohorts. Second, we identified optimal cutoff values of duration of exposure above each concentration of glycemia between 7 and 13 mmol/l using receiver operating characteristic curve analyses in the primary cohort. Optimal cutoff values for predicting stage 3 or higher ROP were 9, 6, 5, 3, 2, 2, and 1 days above a glycemic threshold of 7, 8, 9, 10, 11, 12, and 13 mmol/l, respectively. Severe exposure was defined as at least 1 exposure above 1 of the optimal cutoffs. Severe ROP was significantly more common in infants with severe exposure in both the primary (10.9% versus 0.6%, p < 0.001) and validation (5.2% versus 0.9%, p = 0.030) cohorts. Finally, we analyzed the association between insulin therapy and severe ROP in a national population-based prospectively recruited cohort (EPIPAGE-2, 2011, n = 1,441, mean gestational age 27.3 ± 1.4, boys 52.5%) using propensity score weighting. Insulin use was significantly associated with severe ROP in overall cohort crude analyses (OR 2.51 [95% CI 1.13–5.58], p = 0.024). Adjustment for inverse propensity score (gestational age, sex, birth weight percentile, multiple birth, spontaneous preterm birth, main pregnancy complications, surfactant therapy, duration of oxygen exposure between birth and day 28, digestive state at day 7, caloric intake at day 7, and highest glycemia during the first week) and duration of oxygen therapy had a large but not significant effect on the association between insulin treatment and severe ROP (OR 0.40 [95% CI 0.13–1.24], p = 0.106). Limitations of this study include its observational nature and, despite the large number of patients included compared to earlier similar studies, the lack of power to analyze the association between insulin use and retinopathy. Conclusions In this study, we observed that exposure to high glucose concentration is an independent risk factor for severe ROP, and we identified cutoff levels that are significantly associated with increased risk. The clinical impact of avoiding exceeding these thresholds to prevent ROP deserves further evaluation.
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Black, Maureen M., Howard Dubowitz, Jacqueline Hutcheson, Julie Berenson-Howard, and Raymond H. Starr. "A Randomized Clinical Trial of Home Intervention for Children With Failure to Thrive." Pediatrics 95, no. 6 (June 1, 1995): 807–14. http://dx.doi.org/10.1542/peds.95.6.807.
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Objective. To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive (NOFTT). Design. Randomized clinical trial. Participants. The NOFTT sample included 130 children (mean age, 12.7 months; SD, 6.4) recruited from urban pediatric primary care clinics serving low income families. All children were younger than 25 months with weight for age below the fifth percentile. Eligibility criteria included gestational age of at least 36 weeks, birth weight appropriate for gestational age, and no significant history of perinatal complications, congenital disorders, chronic illnesses, or developmental disabilities. Children were randomized into two groups: clinic plus home intervention (HI) (n = 64) or clinic only (n = 66). There were no group differences in children's age, gender, race, or growth parameters, or on any of the family back-ground variables. Most children were raised by single, African-American mothers who received public assistance. Eighty-nine percent of the families (116 of 130) completed the 1-year evaluation. Interventions. All children received services in a multidisciplinary growth and nutrition clinic. A community-based agency provided the home intervention. Families in the HI group were scheduled to receive weekly home visits for 1 year by lay home visitors, supervised by a community health nurse. The intervention provided maternal support and promoted parenting, child development, use of informal and formal resources, and parent advocacy. Measurements. Growth was measured by standard procedures and converted to z scores for weight for height and height for age to assess wasting and stunting. Cognitive and motor development were measured with the Bayley Scales of Infant Development, and language development was measured by the Receptive/Expressive Emergent Language Scale. Both scales were administered at recruitment and at the 12-month follow-up. Parent-child interaction was measured by observing mothers and children during feeding at recruitment and at the 12-month follow-up, and the quality of the home was measured by the Home Observation Measure of the Environment 18 months after recruitment. Analyses. Repeated-measures multivariate analyses of covariance were used to examine changes in children's growth and development and parent-child interaction. Analyses of covariance were used to examine the quality of the home. Independent variables were intervention status and age at recruitment (1.0 to 12.0 vs 12.1 to 24.9 months). Maternal education was a covariate in all analyses. When changes in developmental status and parentchild interaction were examined, weight for height and height for age at recruitment were included as covariates. Results. Children's weight for age, weight for height, and height for age improved significantly during the 12-month study period, regardless of intervention status. Children in the HI group had better receptive language over time and more child-oriented home environments than children in the clinic-only group. The impact of intervention status on cognitive development varied as a function of children's ages at recruitment, with younger children showing beneficial effects of home intervention. There were no changes in motor development associated with intervention status. During the study period, children gained skills in interactive competence during feeding, and their parents became more controlling during feeding, but differences were not associated with intervention status. Conclusions. Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors. Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income, urban infants with NOFTT. Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT.
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Ropacka, M., W. Markwitz, W. Ginda, and G. H. Bręborowicz. "Ultrasound in the Diagnosis of Twin-to-Twin Transfusion Syndrome – a Preliminary Report." Acta geneticae medicae et gemellologiae: twin research 47, no. 3-4 (October 1998): 227–37. http://dx.doi.org/10.1017/s0001566000000155.
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Objective. The aim of this study was to show the diagnostic possibilities of ultrasound in twin-to-twin transfusion syndrome (TTTS), to demonstrate its usefulness in cases of hemoglobin difference < 5 g/dL in neonates as well as in cases complicated by intrauterine death of one or both twins.Study design. The study included 4 pairs of twins. In two cases 3 fetuses died in utero. In the other two the hemoglobin difference in newborn infants was < 5 g/dL. The ultrasound examination, evaluating the fetal anatomy and biometry, amniotic fluid volume, placentation, was performed. The special attention was paid to polyhydramnios/oligohydramnios, discordant fetal growth (fetal weight, abdominal circumference), the presence of fetal hydrops, ascites, pericardial effusion. Doppler blood flow velocimetry has been done in umbilical vessels, middle cerebral artery. The data was compared with normal reference values for singleton pregnancies. The waveforms from both uterine arteries were also evaluated to exclude placental insufficiency. Additionally the blood flow through the AV valves was measured to exclude or confirm its regurgitation. Postnatally the hemoglobin difference was evaluated if available and compared with sonographic findings.Results. In all cases inter-twin difference in abdominal circumference was greater than 18 mm and inter-twin weight difference of more than 15%. We observed polyhydramnios/oligohydramnios in all twin pregnancies.It has been found decreased PI in middle cerebral artery in larger fetus (recipient) in all our cases (comparing to single pregnancy). PI values for this vessel in smaller fetuses were within normal range (for single pregnancy). PI values in umbilical arteries of recipients were abnormal (increased PI or absent end-diastolic flow).Comments. The sonographic criteria seem to be very useful in diagnosis of twin-to-twin transfusion syndrome, especially in cases where the measurement of hemoglobin level is impossible. Doppler blood flow velocimetry in fetal vessels helps to explain the changes in fetal hemodynamics in TTTS.
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van der Veen, A., RJ Keizer, W. de Boode, A. Somers, R. Brüggemann, R. ter Heine, and P. De Cock. "P99 Clinical validation of published vancomycin population PK models in critically ill neonates." Archives of Disease in Childhood 104, no. 6 (May 17, 2019): e58.2-e59. http://dx.doi.org/10.1136/archdischild-2019-esdppp.137.
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BackgroundVancomycin is commonly used for treatment of severe Gram+ neonatal infections. Currently, even with the use of optimized dosing regimens and therapeutic drug monitoring (TDM), target attainment rates are abominable, leaving patients at risk for therapeutic failure and toxicity. Model-informed precision dosing (MIPD) offers a large potential to improve therapy in the individual patient.The aim of this study was to identify a suitable model for bedside MIPD by assessing the predictive performance of published population pharmacokinetic (popPK) models.MethodsA literature search was conducted to identify parametric popPK models. PK vancomycin data were retrospectively collected from NICU patients at the Radboud University Hospital, Nijmegen, The Netherlands. The model predictive performance was assessed by comparison of predictions to observations, calculation of bias (Mean Percentage Errors, MPE) and imprecision (Normalized Root Mean Squared Errors, NRMSE). Evaluations included both a priori (model covariate input) and a posteriori (model covariate and TDM concentration input) scenarios.Results265 TDM measurements from 65 neonates (median postmenstrual age:32 weeks [range:25–45 weeks]; median weight:1281g [range:597–5360g]; median serum creatinine:0,48 mg/dL [range:0,15–1,28 mg/dL]) were used for model evaluation. Six popPK models were evaluated1–6. A posteriori predictions of all models were consistently more accurate and precise compared to the a priori (starting dose) predictions. PopPK models of Frymoyer et al. and Capparelli et al. consistently performed best through all evaluations in both the a priori and a posteriori scenario (MPE ranging from -18 to 6,4% in a priori scenario and -6,5 to -3,8% in a posteriori scenario; NRMSE ranging from 34 to 40% in a priori scenario and 23 to 24% in a posteriori scenario).ConclusionLarge differences in predictive performance of popPK models were observed. Repeated therapeutic drug monitoring remains necessary to increase target attainment rate. Best performing models for bedside MIPD were identified in our patient population.ReferencesZhao W, Lopez E, Biran V, et al. ( 2013). Vancomycin continuous infusion in neonates: Dosing optimisation and therapeutic drug monitoring. Arch Dis Child;98(6):449–453.Capparelli EV, Lane JR, Romanowski GL, et al. ( 2001). The influences of renal function and maturation on vancomycin elimination in newborns and infants. J Clin Pharmacol, 41:927–934.De Cock RFW, Allegaert K, Brussee JM, et al. ( 2014). Simultaneous pharmacokinetic modeling of gentamicin, tobramycin and vancomycin clearance from neonates to adults: towards a semi-physiological function for maturation in glomerular filtration. Pharm Res;31(10):2642–2654.Frymoyer A, Hersh AL, El-Komy MH, et al. ( 2014). Association between vancomycin trough concentration and area under the concentration-time curve in neonates. Antimicrob Agents Chemother, 58(11):6454–6461.Anderson BJ, Allegaert K, Van Den Anker JN, Cossey V, Holford NHG. ( 2006). Vancomycin pharmacokinetics in preterm neonates and the prediction of adult clearance. Br J Clin Pharmacol;63(1):75–84.Germovsek E, Osborne L, Gunaratnam F, Lounis SA, Busquets FB, Sinha AK. ( 2019). Development and external evaluation of a population pharmacokinetic model for continuous and intermittent administration of vancomycin in neonates and infants using prospectively collected data. J Antimicrob Chemother, 1–9.Disclosure(s)R. Keizer is an employee and stockholder of InsightRX.
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Ivanova, L. A., А. V. Ророvа, and K. P. Karpov. "PROGNOSTIC VALUE OF MORPHOMETRIC PARAMETERS OF ECHOCARDIOGRAPHY AND PLACENTOMETRY." Bulletin of the Russian Military Medical Academy 19, no. 2 (December 15, 2017): 31–36. http://dx.doi.org/10.17816/brmma12173.
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Objective. The aim of the study was to compare the morphometric parameters of echocardiography in a normally occurring pregnancy. Comparison of the obtained data with the data of heart measurement in children perinatally perished, as well as the analysis of the mass indexes of the fetus and placenta in healthy fetuses and fetuses perinatally lost. Materials and methods. We analyzed 94 protocols for the investigation of post-mortem and the protocols for autopsy of fetuses and newborn infants perinatal in various maternity hospitals in St. Petersburg and the Leningrad Region (group 1). The control group 2 consisted of 12 patients who were registered for pregnancy, were examined according to the usual pattern, later they had urgent deliveries to healthy newborns, the histological structure of the placenta was represented by reactive and compensatory-adaptive changes characteristic of the placenta of the normal structure. Patients of control group 2 underwent evaluation of echocardiograms obtained during the third screening test during pregnancy, performed at the time of 32-34 weeks. Control group 3 included 335 observations of full term pregnancy, which resulted in the birth of a healthy fetus. In this group, an analysis was made of the mass indexes of the fetus, placenta, and the integral index of the placental-fetal ratio. Results of the study. Massometric parameters of the fetus, placenta and integral index of the placental-fetal ratio in the patients of the main and control groups were analyzed. Typical changes in the weight of the placenta and placental-fetal ratio in patients with perinatal fetal death were determined. Opportunities were identified for risk groups for perinatal fetal death according to the analysis of the sonocardiogram. Conclusion. 8 conclusions are presented that represent the possibility of predicting perinatal losses depending on the size of the placenta, placental-fetal ratio, the isolation of risk groups for perinatal fetal death according to the data of sonocardiography
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Santos, Andréia Soprani dos, Suele Manjourany Silva Duro, Nágela Valadão Cade, Luiz Augusto Facchini, and Elaine Tomasi. "Quality of infant care in primary health services in Southern and Northeastern Brazil." Revista de Saúde Pública 52 (January 29, 2018): 11. http://dx.doi.org/10.11606/s1518-8787.2018052000186.
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OBJECTIVE: To assess the quality of the health care provided to children aged under one year old performed by primary health services in the South and Northeast regions of Brazil. METHODS: This is a cross-sectional, population-based study carried out in 2010 with 7,915 children aged from one to four years, whose homes are located in the areas of health service coverage. We described the prevalence of procedures and guidelines, such as weight and height measurement, vaccination, newborn blood spot screening, evaluation of umbilical cord, instruction on breastfeeding and introduction of new food, and their respective 95% confidence intervals. The differences were analyzed using the chi-square test of heterogeneity and linear trend. We considered the main outcome of high-quality infant care if the child had received all recommended procedures and guidelines in the first year of life. For this analysis, we used the Poisson regression considering hierarchical model. RESULTS: There was low prevalence for the instruction on breastfeeding in the first week of life (58.8%, 95%CI 57.5–60.0) and on the introduction of new food in the fourth month care. The prevalence of high-quality in childcare was 42.0% (95%CI 40.5–43.5). The adjusted analysis according to hierarchical model indicated greater probability of this outcome in the Northeast region (PR = 1.17, 95%CI 1.09–1.26), in smaller municipalities (PR = 1.17, 95%CI 1.03–1.33), and in municipalities with 50,000 and 99,000 inhabitants (PR = 1.20, 95%CI 1.09–1.34). CONCLUSIONS: The Northeast region has higher-quality infant care services, which can be explained by the consolidation of the Family Health Strategy in that region.
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Rustamaova, Saida Nuraddin. "Nutritional problems and factors of forming the health of children of the first year." UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS, no. 3(87) (September 29, 2021): 23–29. http://dx.doi.org/10.15574/pp.2021.87.23.
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Evaluation of the type of nutrition, which is one of the important components that ensure the physical growth, development and health of a child in the first year of life, and that forms metabolic processes at an older age, has been the subject of research and discussion of domestic and foreign scientists over the past decades. Purpose — to study the influence of the nature of feeding on the incidence and physical development of infants. Materials and methods. During the year, 250 children (118 girls and 132 boys) of the first year of life were under observation, who received various types of feeding (breast milk and milk formulas, differing in composition). The main (I) group (n=130) included children (62 girls and 68 boys) who were breastfed; and in the comparison group — children receiving artificial feeding: in group II (n=60) (27 girls and 33 boys) received a standard mixture with a prebiotic; in group III (n=60) (29 girls and 31 boys) — a standard mixture without a prebiotic. Physical development was assessed according to the generally accepted measurement technique in terms of absolute values, monthly increases in anthropometric indicators and mass-growth indices. Outpatient records of children, protocols of examination of a 1-year-old child were studied (accounting and reporting documentation was analyzed). The criteria for inclusion in the main group of infants were: breastfeeding for at least 9 months; the age of children from up to 1 year of age. The second comparison group included children who were fed mixed with the addition of probiotic means. Results. In girls of the second group, who were artificially fed with the addition of a probiotic — 7100.0±95.9 g, the weight gain in the first year of life was significantly higher than the weight gain of girls who received breast milk and standard formula — 6671.0±72.6 g and 6733.3±91.8 g, respectively. Despite the fact that there were no significant differences in the medians of body weight and height in children of the main group and the comparison groups, it was found that children in the main group were overweight/obese at 12 months had two or more times less indicators than children who received artificial nutrition. Children who are breastfed began to sit independently much earlier, on average 7.6±0.05 months after birth, and children of the other two groups who are bottle-fed, on average, 8.0±0.13 and 8.1±0.12 months, respectively (p<0.05). When studying the structure of the most common diseases of children in the first year of life, depending on the type of feeding, it was revealed that the greatest percentage both in group I (group) and in group II (claim) are children with acute intestinal infections — in group I (group 1)) group in 7.7±2.34% of children, in subgroup II (claim) in 11.7±2.93% of children (p=0.3905). Conclusions. The results obtained indicate a positive effect of breastfeeding on anthropometric indicators and the formation of basic skills in young children. The incidence of infectious diseases (ARI and OCI) revealed in children who received breast milk, compared with children who are bottle-fed, indicates that breastfeeding has the ability to create conditions for reducing the incidence of diseases in young children. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: types of feeding, physical development, motor skills, morbidity, children under 1 year old.
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Yadav, Ramesh, and Hemsagar Rimal. "Changes in Level of C-reactive Protein at 0 hours and at 72 hours among Neonates with Suspected Sepsis at Neonatal Intensive Care Unit of Birat Medical College Teaching Hospital." Birat Journal of Health Sciences 6, no. 3 (December 31, 2021): 1636–41. http://dx.doi.org/10.3126/bjhs.v6i3.43213.
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Introduction: Neonatal sepsis still remains serious and potentially life-threatening events with a mortality rate of up to 50% in very premature infants. Efforts were made to improve laboratory sepsis diagnosis. C-reactive protein (CRP) is the most extensively studied acute phase reactant so far. Very few studies have been done to see the variation of serial measurement of CRP titer. Objectives: To find out the level of CRP titer at 0 hour and at 72 hours among neonates with suspected sepsis at the neonatal intensive care unit of Birat Medical College Teaching Hospital. Methodology: It was a cross-sectional descriptive study from 26 March 2021 to 25 July 2021, to see serial CRP titre among the sepsis suspected neonates at the Neonatal intensive care unit of Birat Medical College Teaching Hospital. A Total of 95 cases of neonates suspected sepsis were enrolled and their serial CRP titre at o0 hour and 72 hours were studied. The data was entered into Microsoft office excel and analyzed using statistical package for social sciences (SPSS 20.0) Results: There was no significant association of gender, birth weight, mode of delivery and gestational age with an increase of CRP at 0 to 72 hours after birth. Among the enrolled neonates 34 had positive blood culture while 61 had blood culture which was sterile. It showed that, 70.6% who had blood culture positive had increased CRP level at 0 to 72 hours whereas only 29.4% had not no increment in CRP despite positive blood culture. Conclusions: CRP titre increment at 72 hours after the first one correlated better with culture proven sepsis in comparison to CRP titer increment at 0 hours after birth. The sensitivity, specificity, positive and negative predictive values as calculated in this study are not high enough to make it a good screening test. The test is not specific enough to rely upon as the sole indicator. The clinical judgment along with other hematological parameters and diagnostic markers along with serial CRP should be considered in evaluating a neonate for sepsis.
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Bertino, Enrico, Silvano Milani, Luisa Boni, Alessandra Coscia, Gessica Rossetti, Tiziana Testa, Francesca Giuliani, Irene Appino, Elena Spada, and Claudio Fabris. "Evaluation of Postnatal Weight Growth in Very Low Birth Weight Infants." Journal of Pediatric Gastroenterology and Nutrition 45, Suppl 3 (December 2007): S155—S158. http://dx.doi.org/10.1097/01.mpg.0000302963.85922.d4.
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COOKE, RICHARD J., SUSAN WERKMAN, and DONNA WATSON. "Urine Output Measurement in Premature Infants." Pediatrics 83, no. 1 (January 1, 1989): 116–18. http://dx.doi.org/10.1542/peds.83.1.116.
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Determination of urine output is important for clinical care and research of the premature infant. This is achieved by placing a urine bag with adhesive edges on the infant, aspirating the bag, and determining the volume of urine therein. Unfortunately, urine leakage occurs around the bag. To account for such losses, the infant is placed on a preweighed, absorbent diaper. Urine output then is determined from the volume of urine in the bag and the increase in the weight of the diaper that has occurred between urine collections. The purpose of this study was to quantitate the confounding effect of evaporation on diaper weights when diapers are placed under a radiant warmer or in an isolette.
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Gaze, Sian, Falak Latif, and Kim Wolff. "P004 An evaluation of the management of thrombosis in neonates and infants using dalteparin." Archives of Disease in Childhood 104, no. 7 (June 19, 2019): e2.6-e2. http://dx.doi.org/10.1136/archdischild-2019-nppc.14.
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AimTo assess the safety and efficacy of the current dalteparin dosing recommendations in achieving therapeutic anti-Xa levels, when used for the treatment of thrombosis in neonates and infants. The objectives included: To assess the number of neonates/infants administered dalteparin for thrombotic events To evaluate how many neonates/infants achieved a therapeutic anti-Xa level (4 hour post-dose level of 0.5–1 unit/ml) To measure the duration between starting dalteparin and achieving a therapeutic anti-Xa level.MethodsRetrospective electronic searches were conducted to identify neonates and children prescribed and administered dalteparin between January 2016 and October 2017. These included reports from the JAC pharmacy dispensing programme, Medchart (electronic prescription chart) and Omnicell (ward electronic medicines storage system). A data collection from was designed using Excel, and piloted on a few randomly selected patients. Following the pilot, appropriate changes were made to the form. Inclusion criteria included: Treatment doses of dalteparin Neonates/infants under 12 months age Exclusion criteria included: Dalteparin thromboprophylaxis Missing data e.g. no anti-Xa levels recorded Patients were started on dalteparin using the dosing recommendations outlined in the dalteparin monograph in the Hospital paediatric formulary and the Trust’s Paediatric thrombosis guideline: 150 units/kg twice a day for babies under 5 kg 100 units/kg twice a day for babies over 5kg Doses that achieved therapeutic peak anti-Xa levels (4 hour post dose level of 0.5-1 unit/ml) were obtained by analysing the patient’s Medchart (electronic prescription chart) and electronic patient record (EPR). The duration between receiving an initial dose of dalteparin and achieving a therapeutic anti-Xa concentration was recorded to evaluate clinical effectiveness. Creatinine, urea and platelet measurements were analysed to assess the safety of dalteparin, as dalteparin can accumulate in patients with renal impairment, and thrombocytopenia is a common side-effect.ResultsA total of 25 patients were included in the study: 18 neonates and 7 infants. In the neonatal group, ages ranged from 32 weeks preterm to 42 days post term delivery. The median age at time of dalteparin administration was 15 days. Weights ranged from 1.8 kg to 4.2 kg. In the infant group, ages ranged from 2 to 11 months. Weights ranged from 3.2 kg to 11.7 kg. 100% (25/25) patients achieved a therapeutic anti-Xa level; however, 100% (25/25) patients required dose adjustments to reach these levels. The mean dose required to reach therapeutic anti-Xa levels in neonates and infants was 250 units/kg (±60) and 140 units/kg (±50), respectively. In neonates, the duration between initial dalteparin administration and achieving therapeutic anti-Xa levels ranged from 2–8 days. In 8/18 (44%) patients, it took a minimum 5 days to achieve therapeutic anti-Xa levels. No episodes of renal impairment or thrombocytopenia were observed.ConclusionDalteparin was successful in achieving therapeutic anti-Xa levels in neonates and infants following cumulative dose increases from the initial dose. The initial recommended dose of dalteparin for neonates is too low and should be increased to 250 units/kg achieve therapeutic anti-Xa levels quicker, and to minimise the need for numerous blood tests and dose adjustments. Further studies are required to verify these results, due to the small patient numbers.
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Appel V, Inge M., Andreas Machotta, Marten Poley, and Maiwenn J. Al. "Thrombelastography-Based Monitoring for Massive Blood Loss During Elective Pediatric Surgery for Craniosynostosis Repair, a Pilot Study." Blood 114, no. 22 (November 20, 2009): 2110. http://dx.doi.org/10.1182/blood.v114.22.2110.2110.
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Abstract Abstract 2110 Poster Board II-87 The management of massive blood loss in children during trauma or major surgery is still an unsolved problem in pediatric surgery and anesthesia. Primary operative repair of craniosynostosis in infants and young children can serve as a model for excessive acute blood loss. The introduction of thromboelastography (TEG) has led to a significant decrease in transfusion of packed red blood cells (pRBC), fresh frozen plasma (FFP) and platelets in adult surgery, thereby diminishing the risks of infections and immunosuppression. Moreover a significant decrease in accompanying costs has been reported. However, no studies have evaluated the effect of TEG-guided treatment on the amount of transfused blood products in children. The primary objective of this pilot study is to obtain reference TEG-values in children during surgical repair of primary craniosynostosis. We performed a single-center pilot study on TEG-monitoring in children during craniofacial surgery. Methods: The study includes 21 children with craniosynostosis undergoing elective craniofacial repair at the Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands. Blood samples (5 ml blood taken from an arterial line) for TEG (Haemoscope®) measurement were obtained after induction of anesthesia (T1), after the application of Ringer's lactated solution (RLS) 10 ml × kg-1 body weight (T2), after the application of hetastarch 130/0.4 6% (Venofundin®, Fresenius Kabi) (T3), after transfusion of pRBC (T4), and eventually after the application of FFP (T5). Results: 21 children, less than 20 months of age, with a mean body weight of 8.5 kg underwent surgical repair of craniosynostosis. They were treated according to the local protocol on massive blood loss in children during surgery. Nine children were suffering from scaphocephalie, 4 from trigonocephalie, 3 from plagiocephalie, one from brachycephalie and 4 children had a mixed or complex form of craniosynostosis such as Crouzon disease. After the induction of anaesthesia (T1) and after the administration of RLS (T2) no changes in clot strength were seen, MA remained mean 62 mm. However, between T2 and T3 all children demonstrated a significant decline in hemoglobine from mean 6.5 to 3.8 mmol/L (p<.0005). The blood loss was mean 380 ml at T3, ranging from 200 to 700 ml, requiring mean 190 ml transfusion of pRBC (range 100-390 ml). The TEG values at T3 showed a concurrent decrease of alpha (from 66° to 57°) and MA (from 62 to 48mm) with an increasing k (from 1.7 to 3.0 min) in kaolin activated TEG measurements. Together with a decrease in MA in TEG–FF at T3 (from 18 to 5.5 mm) this demonstrates a dilutional coagulopathy. All changes were highly significant with p<.0005. Transfusion of pRBC at T4 did not change TEG parameters. No signs of fibrinolysis were seen. Discussion: The administration of hetastarch 130/0.4 6% at T3 resulted in a dilutional coagulopathy. This is due to blood loss, consumption of coagulation factors and platelets, and intravascular volume replacement. During blood loss fibrinogen synthesis will be limited. Additionally, the decreasing functional fibrinogen levels (MA-FF) point to reduced strength of the clot. Administering cryoprecipitate or concentrates of fibrinogen in an early phase might maintain clot firmness and thereby decrease blood loss and reduce the number of transfused blood products. Conclusion: In an attempt to decrease the amount of transfused blood products TEG will allow tailored interventions during pediatric surgery with specific medications like antifibrinolytic agents, concentrates of fibrinogen, or activated recombinant factor VII. Finally, TEG tailored therapy may decrease blood transfusions and transfusion related complications in children. These data strongly support the evaluation of TEG-guided interventions in children during massive blood loss. Disclosures: No relevant conflicts of interest to declare.
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Gelbart, Ben, Kate Masterson, Alyssa Serratore, Michael Zampetti, Andrea Veysey, Stacey Longstaff, Rinaldo Bellomo, Warwick Butt, and Trevor Duke. "Precision of weight measurement in critically ill infants: a technical report." Critical Care and Resuscitation 23, no. 4 (December 6, 2021): 414–17. http://dx.doi.org/10.51893/2021.4.tn.
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Rasoulinejad, Seyed Ahmad. "Evaluation of Retinopathy of Prematurity in Preterm Infants." International Journal of Ayurvedic Medicine 10, no. 2 (July 15, 2019): 185–88. http://dx.doi.org/10.47552/ijam.v10i2.1280.
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Background: Retinopathy of Prematurity is aberrant developmental retinal Angiogenesis in preterm infants. For ophthalmologist diagnosis and management of this progressive disease remains a challenge. Objective: To investigate the retinopathy of prematurity in premature infants referred to the Eye Clinic of Ayatollah Rouhani Hospital in Babol in 2016. Methods: In this cross-sectional study, data on premature infants including risk factors for retinopathy and eye examinations were recorded and data were analyzed using Chi-square, single, and multiple logistic regression. Results: Among 100 premature infants with mean gestational age, 31. 83 (GA) weeks (2. 06SD) and birth weight 1686. 9 (g) (416. 4SD), retinopathy was 39% and severe in 14% of all specimens. In single-variable analysis, there was a significant relationship between Retinopathy of Prematurity and birth weight, gestational age, duration of oxygen therapy, duration of hospitalization and sepsis, while in multivariate logistic regression, birth weight and respiratory distress syndrome were independent predictors of retinopathy. 25 cases (64. 1%) had spontaneous regression and in 14 cases (35. 8%) treatment was required. The prognosis of treatment was desirable in all 14 cases. Conclusion: Timely screening and treatment in infants with severe retinopathy is very important in preventing progression of the disease to higher stages and poor vision prognosis.
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Abdel Mohsen, AbdelHakeem, Gamal Taha, BothinaA Kamel, and MohamedAbdel Maksood. "Evaluation of aldosterone excretion in very low birth weight infants." Saudi Journal of Kidney Diseases and Transplantation 27, no. 4 (2016): 726. http://dx.doi.org/10.4103/1319-2442.185234.
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